Author Archive for: Kathy Rooker

April 23rd, 2012

Not many things really leave me speechless. This situation did just that. I will start by saying this was a space the practice was using for 9-12 months while new office space was being built.

I had completed the facility safety part of my mock OSHA Inspection and was ready to ask questions about cleaning and disinfecting instruments.

I was told the office performed pap smears and some minor surgical procedures. I also knew they did some waived lab testing in the practice.

Usually the instrument disinfecting is done in the lab, so I asked the medical assistant to take me to that area. As we walked down the hall, it looked to me like we were headed to a door that was clearly marked “Restroom.”

February 6th, 2012

When I perform my mock OSHA Inspections, I always ask the practice about their sterilization and disinfecting procedures. Recently I was walking down the hall in an office and I saw a staff member wiping some type of tube or wire down with a cloth.

Let’s just say, I was more than curious about what I had just witnessed. At that point, I hadn’t questioned the staff on what instruments and equipment they were using in the office.

The tubing was actually a laryngoscope that had just been used for a procedure. When I questioned the medical assistant, she told me she was disinfecting the instrument with the disinfecting cloth.

Keep in mind, these cloths are specifically manufactured to be used as a surface disinfectant, such as for a counter top.

She told me that was how she had been instructed to disinfect the laryngoscope.

I asked her what her next step would be and she replied she would rinse the scope with soap and water and dry before the next use.

My next question was: Had she read the manufacturer’s instructions on how to properly disinfect this instrument?

She replied, “No.”

ALWAYS READ THE INSTRUCTIONS!

I invited the medical assistant to sit down and chat with me. First of all, this scope is classified as semi-critical and should be disinfected with a high level disinfectant such as glutaraldehyde or a peroxide-based solution, I explained.

The first step in the process is to clean the scope to remove all visible debris. The scope is manually cleaned with low foaming enzymatic cleaner. Next, thoroughly rinse the scope and let air dry before placing in the high level disinfectant.

Never use disinfectant impregnated wipes as the sole means of decontamination.

The majority of laryngoscope blades are disposable. If they are reusable, follow the manufacturer’s instructions to either autoclave or use a high level disinfectant. And remember, the scope handles are considered contaminated, and must be properly cleaned between patients.

November 9th, 2011

In the past few months, I have been in eight physician offices that are still using non-safety needles, lancets, or scalpels. I have heard every excuse in the book for not switching to safety devices.

I am totally shocked that one medical assistant (MA) had no clue that safety needles were supposed to be used when giving an injection. The first thing she said was “why didn’t my supply vendor tell me this?”

August 5th, 2011

In the past year I have performed over 100 mock OSHA inspections. I have heard every excuse in the book for not complying with OSHA regulations and CDC guidelines applicable to healthcare settings.

Many times the excuse for noncompliance is that someone told them to do/not to do whatever it is we are discussing. I am going to share some of the bad advice that physician offices have been given by consultants, experts, and even colleagues.

February 24th, 2011

When I do a mock OSHA inspection, I always look at the sharps containers. I check to make sure discarded sharps items have not exceeded the fill line. If the sharps container is clear, I can easily see what’s inside. Otherwise, I try to look down into the container.

I look for scalpels that do not have sheaths over the blades, non-retractable lancets, and needles that are non-safety engineered.

On a recent inspection, I knew that the practice I was inspecting was using all safety devices, so what I found was very surprising!

November 5th, 2010

During a recent mock OSHA inspection, I asked the office manager if I could review the written workplace violence prevention plan. She walked me to the front office area and said, “We don’t need anything written down, we just get this out.” Under the receptionist counter was a baseball bat.

October 19th, 2010

During my mock OSHA inspections, I always ask to see the practice’s OSHA manual. I have seen manuals that haven’t been touched for so long that I could blow dust off them.

Sometimes no one in the practice can find the manual. During an inspection last week, the OSHA manual was a collection of notes from previous OSHA seminars. I even saw one of my handouts from a seminar I taught years ago. The manager thought she could just put the power point hand-outs in a notebook and call it her OSHA manual.

July 22nd, 2010

I was almost done with my mock OSHA inspection in an OB/GYN office, and the last section of my survey covered decontaminating and disinfection.

One of the physicians was leaving an exam room holding a metal vaginal speculum in a paper towel. I could not believe what I was seeing! Luckily I didn’t collide with him, but I saw him soon enough to follow up on my concern.

Kathy Rooker is the safety officer and owner of Columbus Healthcare & Safety Consultants, Canal Winchester, OH (krookerchsc@gmail.com or 614-833-9092). Rooker has more than 35 years experience working in the healthcare field and currently provides OSHA and CLIA consulting and inspections for physician practices and conducts OSHA annual training seminars in and around Central Ohio. In her "Notes from the Field" posts, she shares real life OSHA compliance issues and offers solutions to these sometimes complicated situations.